Memorial HealthWatch Winter 2008

Moving Forward with Photopheresis

Bone marrow transplantation can be an effective way of treating a number of diseases, including leukemia, lymphoma and multiple myeloma. However, as with any highly advanced form of medical treatment, there are risks of complication. One of those is graft-versus-host-disease (GVHD), which occurs when the bone marrow rejects and attacks the new host's body.

Medication can help, but sometimes even after two or three different drugs are tried, the GVHD remains. When that happens, a simple, painless treatment called photopheresis can eradicate GVHD — and Memorial Cancer Institute's Photopheresis Unit at Memorial Hospital West is the one facility in Broward County where transplant patients with this complication can undergo the procedure.

Harnessing the Power of Light

Daren Grosman, MD, hematologist/oncologist at Memorial Cancer Institute, explains the process this way. "'Pheresis' means to remove blood and return it. Photopheresis is a treatment in which the patient swallows a chemical and is then hooked up to a machine. The chemical enters the patient's blood, then the blood leaves the body and circulates through the machine, which has a UV light source inside it. The UV light source activates the chemical in the patient's T-cells, which are the bad cells, and basically explodes them, but leaves the healthy cells intact. So essentially it removes the offending cells, deleting GVHD from the immune system's memory."

Photopheresis also works to combat a form of skin cancer, cutaneous T-cell lymphoma (CTCL), which can be sent into remission for long periods of time using the treatment. In Florida, there is a particularly high incidence of CTCL, and Dr. Grosman confirms that a large number of patients undergo photopheresis at Memorial for the condition, with highly positive results.

Photopheresis is entirely painless and comfortable for the patient, and each session is four hours long. While GVHD patients generally take treatment weekly or biweekly, CTCL patients need only undergo the procedure every two to four weeks.

Increasing Access to Care

Memorial's first photopheresis machine became operational less than a year ago, but because there is such a need for it and it has been so successful, a second machine was recently installed. "We had to take over another room in the cancer program to house it, because there is such a tremendous need," Dr. Grosman says. "It has been a phenomenal success."